A 50 year old woman presents with the rash shown above as well as ankle edema. She has a history of hypertension, hyperlipidemia, diabetes, Parkinson's disease, asthma, GERD, gastritis, osteoporosis, osteoarthritis, hepatitis B, gout, and anxiety disorder. Her medications are: metoprolol, lisinopril, atorvastatin, insulin (glargine and lispro), levodopa, amantadine, albuterol inhaler, ranitidine, omeprazole, vitamin D, ibuprofen, fluoxetine, glucosamine, St. John's wort, and feverfew! The culprit for the rash is shown below.
Challenge: What's the culprit?
First image shown under Fair Use. Second image is in the public domain.